House Passes Interior Appropriations Bill, Includes $7.078 Billion for the Indian Health Service and Maintains Advance Appropriations
On November 3, 2023, the House of Representatives voted to approve the Fiscal Year (FY) 2024 Department of Interior, Environment, and Related Agencies Appropriations Act with a vote of 213 to 203. The bill provides a discretionary spending total of $25.417 billion, which is $13.433 billion below the FY23 enacted level and $21.37 billion below the President’s Budget Request. Despite the sizeable cut to the Interior, Environment, and Related Agencies bill, the Indian Health Service (IHS) received a 2.2% increase.
The bill authorizes $7.078 billion for IHS— an increase of $149 million from FY23 but $2.6 billion below the President’s request. Advance appropriations for IHS were maintained for FY25 and increased from $4.9 billion in FY24 to $5.8 billion for FY25. The bill also authorizes $115 million for the Urban Indian Health line item, a $15 million increase from the FY23 enacted level. Other key provisions include: $3 million for generators at IHS/Tribal Health Programs/Urban Indian Organizations (UIOs), $6 million for the Produce Prescription Pilot Program for Tribes and UIOs to increase access to produce and other traditional foods, as well as $35 million for Tribal Epidemiology Centers (TECs).
| Line Item | FY23 Enacted | FY24 TBFWG Request | FY24 President’s Budget | FY24 House Passed |
| Urban Indian Health | $90,419,000 | $973,590,000 | $115,150,000 | $115,150,000 |
| Indian Health Service | $6,958,223,000 | $50,996,276 | $9,700,000,000 | $7,078,223,000 |
| Advance Appropriations | $5,129,458,000 | $9,100,000,000 | $5,129,458,000 | $5,878,223,000 |
Next Steps
On November 15, 2023, Congress passed a Continuing Resolution (CR) that will keep the government funded through the beginning of 2024. Until the CR expires, the House and Senate will remain in negotiations to pass a bill that will fund the government through the rest of the fiscal year. Although the House of Representatives passed their version of the bill, it is unlikely to pass through the Senate. NCUIH will continue to monitor the state of appropriations and advocate for House-level funding in any funding negotiations or Omnibus legislation. The Senate introduced a separate Interior Appropriations bill on July 27, 2023. This bill has passed out of the Senate Appropriations Committee and is awaiting a full Senate vote. A date for this vote has not been set.
Background
On July 18, 2023, the House Appropriations Subcommittee on Interior, Environment, and Related Agencies released the Committee Bill Report for the FY24 budget with $115,156,000 for Urban Indian health. The bill appropriates $25.4 billion for Interior, Environment, and Related Agencies, which is $13.4 billion below the fiscal 2023 levels and $21.3 billion below the Biden Administration’s request. Despite the sizeable cut to the Interior, Environment, and Related Agencies bill and reducing funding for nearly every account to below FY23 enacted levels, the Indian Health Service (IHS) received a 2.2% increase.
The report and bill were approved by the House Subcommittee on Interior on July 13, 2023 and approved with amendments by the full House Appropriations Committee on July 19, 2023. The bill authorizes $7.078 billion for IHS— an increase of $149 million from FY23 but $2.6 billion below the President’s request. Advance appropriations for IHS was maintained for FY25 and received an increase to $5.8 billion from $4.9 billion in FY24.
On March 9, 2023, President Biden released his budget request for FY24 which included $9.7 billion for IHS and proposed mandatory funding for IHS from FY 2025 to FY 2033 to the amount of $288 billion over-ten years as well as exempting IHS from sequestration.
